| Adherence to inhaled steroids is a significant problem for children with asthma and few studies have evaluated adherence improvement interventions. The current study examined the effect of an adherence intervention including focused education, parental monitoring, contingency management and discipline strategies. The present study also included an attention-control group, which received standard care plus a comprehensive asthma education program. Participants included fifteen children, ages 7–12 years, and their families, with seven participants in the treatment group and eight participants in the control group. Daily adherence data were collected via electronic monitors. Measures of disease outcome including pulmonary function, quality of life, and health care costs were also obtained. Adherence data were analyzed using Pooled Time Series Analysis (PTSA), a statistical method that capitalizes on multiple observations for a small number of participants while providing considerable statistical power. Using this method, the treatment group exhibited significant increases in adherence over the length of the treatment. Repeated measures Analysis of Variance (ANOVA) were conducted to examine pulmonary function, quality of life, and health care costs between the two groups. Although statistically significant differences were not obtained, both the treatment and control group demonstrated clinically significant improvements in pulmonary function and quality of life and clinically significant decreases in health care costs. These results indicate the intervention was effective in improving adherence and resulting in clinically meaningful changes in several measures of disease outcome. |
